Retin-A: A Love Story

Tiffany (not her real name) came up to me during recess (because for some reason, even in sixth grade we had recess) and asked, “What’s on your face?” She pointed at the scabby spot on my chin and smirked as I turned red and squirmy, a cabal of Tiffanys watching her watching me.

I felt my eyes well up, and muttered something like, “I accidentally scratched myself,” as I put a hand up to my chin, covering up the remnants of the angry red cyst I tried to pop that morning, not yet understanding that cystic acne was completely different from the blackheads and whiteheads I was already very acquainted with.

For my efforts, I was rewarded with a swollen, throbbing, chin and scabby indents where my fingernails dug into my skin, a lovely addition to the other scabs and scars left behind by previous breakouts.

What I couldn’t understand then, and still can’t, is why Tiffany pointed it out. I mean, obviously I know that she was a bully and that’s how bullies operate. They find a weakness and go after it. But what satisfaction would she have gotten by hearing me say, “It’s cystic acne, Tiffany. And man, it sucks.” Like, did she want me to talk to her about acne? Did she want to hear me say the word “zit” or “pimple”? I have no idea.

Thus began a nearly 20 year struggle with acne, and an aversion to being photographed. The cystic kind was mainly confined to my chin and seemed to be hormonal in terms of when it appeared. I left it alone and focused on getting really good at concealing. But it was the regular acne, on my cheeks and forehead, that baffled me. And I know on the scale of moderate to severe, my acne was moderate, but it was very, very consistent.

I did all the things and bought all the stuff the magazines and commercials told me to. Some worked (salicylic acid products seemed to be the best for my skin), others (witch hazel, Sea Breeze, anything that contained benzoyl peroxide) just made things worse.

I first heard about Retin-A, the prescription-strength version of vitamin A, a pore-unclogging, wrinkle-reducing miracle drug, sometime during the 90s when I was in college. But it would be nearly nine years later, when I finally got decent insurance, that I was able to try it for myself.

A bad reaction to Shu Uemura cleansing oil (the year the brand collaborated with Moyoco Anno on some really amazing bottle designs) was what finally forced me to make an appointment with a dermatologist. I know the oil cleansing method works for many people with acne-prone skin, but it turned my face into a red, bumpy mess.

My derm examined my skin and declared me a great candidate for Retin-A Micro, explaining how/when to use it (a pea-sized amount; only at night; sunscreen during the day, although the link between Retin-A and sunburns has since been debunked).

But most important, he said, “You have to stick it out. You’re probably going to feel some discomfort for the first two or three weeks, but once your skin adjusts, you’re going to love the results.”

"Discomfort" was putting it mildly. Those first three weeks were awful: redness, peeling, tightness, an itchiness I couldn't quite put into words--like my skin was itching on the inside. My face was breaking out like mad, and it was so sensitive that an encounter with a zipper (I was getting dressed in a hurry one morning) resulted in a scrape that made my cheek bleed for nearly an hour. And the flakiness--I looked like I was molting.

But then something amazing happened: Come week four, my skin, though still a little red and flaky around the nose, was clearer than I could ever remember it being. Two months in, most of the major acne scars I had were faded, the minor ones totally gone. Four months in and the deep chicken pox scars on my forehead from when I was a toddler were much harder to see. And if I did have a garden-variety breakout, the recovery time was practically overnight.

What’s even more incredible is that some seven years later, Retin-A still works just as well as it did in the beginning. And I don’t even use it as regularly as I used to--every two or three nights is enough to keep things in check.

Retin-A, great as it’s been for me, is not a miracle drug. For cystic breakouts, cortisone injections at the derm’s office are the only thing that help get rid of those fast, and that’s not a very practical solution. Also, if your insurance doesn't cover it, the cost can be steep--$200 and up; there is a generic equivalent, Tretinoin, which is what I use, and it's around $50. And for some people, those beginning weeks are just too much to handle or their skin is too sensitive to tolerate it, which you may only find out by suffering through those terrible early days.

But still, I recommend it to people all the time--especially those who tell me I have good skin, because 6th-grade me would get such a kick out of that and I want her to know that everything turned out OK in the end.